Category Archives: Cosmetic Dentistry

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This may sound like a trick question, but really it’s not. The “correct” answer, of course, is that both are equally important. But, I have a different view and will share it later in this article.

Both gums and teeth require good to excellent daily hygiene to remain healthy. Prevention of both periodontal disease and dental decay is accomplished using the same techniques and products. Both gum disease and dental decay are caused by the attack of bacteria which produce acid. This acid causes damage to both hard and soft oral tissues including gums, enamel, dentin and bone. Both conditions if not properly and promptly addressed will result in the eventual loss of teeth as well as the inability to properly chew food. And, both problems are a source of embarrassment and self consciousness due to missing teeth, bad breath, swollen and red gums, black holes, etc., etc.

Both teeth and gums are checked at every dental re-care appointment. Commonly, both of these dental diseases go unnoticed by patients until more involved and expensive treatments are required. In the case of cavities, decay which has advanced to the point when a patient feels pain will generally require root canal therapy. And, in the case of gum disease, by the time a patient realizes that there is a problem, the solution often involves the services of a periodontist, possible gum surgery and / or loss of teeth. Unrecognized and untreated periodontal disease will eventually lead to loose teeth as a result of the loss of bone and the attachment of the teeth.

Finally, both gum disease and tooth decay result in the existence of chronic infection and inflammation which has detrimental affects on the overall health of the body. A chronic infection which becomes acute, can result in serious illness which may require hospitalization. The hidden impact of such diseases, however, is that these chronic inflammations increase the risk of other health issues including heart disease, cancer, complicated births, etc.

As promised, my view whenever planning the treatment for patients and explaining its need is that once acute infection and pain are under control, the health of the gums is the number one priority. Consider the gums and bone to be the foundation which supports the teeth. Without a solid foundation, even the healthiest teeth can be lost. Once the periodontal condition is stable and healthy, then the teeth can be addressed as needed.

If you have any questions about gum disease or dental decay, please feel free to contact us by telephone @ 908.359.6655 or via our website www.DesignsForDentalHealth.com

Invisalign is a system for straightening teeth and improving the bite which is an alternative to conventional metal orthodontic “braces”. This system utilizes a series of clear plastic aligners, each of which is worn 22 hours per day for a period of 2 weeks. The company began in 1997 and has gone through a series of improvements which have made this method increasingly utilized and accepted by the dental community as well as patients.

There is no question that our practice is seeing more and more adult patients who request Invisalign to improve their bite and appearance, as well as to help turn back the clock.

There are a number of conditions which can be addressed using this system:

Those who had orthodontics as a child but have seen significant relapse over the years.

Patients who are concerned about the shifting or increasing misalignment of their teeth.

Those who have teeth which are wearing down unevenly.

Patients with teeth that appear crowded or misaligned.

Those who have an underbite, overbite or open bite.

In some cases, those who have gaps between their teeth.

Increasingly, those who desire to improve their appearance and look younger.

Click this image for a concise video on Invisalign.

There are significant benefits of Invisalign as compared to conventional metal orthodontics:

There are no dietary restrictions because the aligners are removed before eating.

There are no special dental hygiene requirements because the liners can be removed to brush and floss the teeth.

Because the aligners are made from a clear plastic material, they are practically invisible.

As the system begins with a virtual treatment plan called a “ClinCheck”, both the dentist and the patient are provided a digital preview of the treatment. This preview, if used properly, helps to determine how well the treatment will result. In our experience, patients truly enjoy this preview and its use to track the progress of their case. It’s important to note that In some severe cases, the use of Invisalign may not offer the best solution. Some cases may still require either surgical intervention, conventional metal braces or a combination of the two.

There are several long-term benefits of having straight teeth and a good bite:

Straight teeth are easier to keep clean and food particles and plaque are not trapped in uneven spaces. The result is a decreased likelihood of both dental decay and gum disease.

Healthier teeth and gums contribute to a person’s overall systematic well-being and health.

Uneven wear due to misaligned teeth is alleviated.

Patients enjoy a more confident smile and an improved, more youthful appearance.

Can You Just Fill It?

One question that dentists are asked all the time is: “Can you just fill it?” My goal with this particular article is to answer just that question. And the answer is: That depends on several factors. First and foremost are the needs and desires of the particular patient. Equally important is the condition of the tooth or teeth in question.

First, let me begin by explaining that nearly all of today’s tooth restorations are made of ceramic. Ceramic encompasses the materials most commonly used to restore teeth today. This includes porcelain in various forms as well as composite, commonly known as “plastic” fillings. In our practice, metal is rarely used except in specific cases where achieving a quality bond is impossible (deep under the gum) or the strength of metal is mandatory. Ceramic materials offer a beautiful, lifelike appearance and can be bonded to tooth structure for strength and longevity.

The choice of whether to use a composite filling or some type of porcelain restoration is dependent upon the following five conditions:

1. The size of the cavity

Composite fillings makes sense when the cavity – whether caused by decay or fracture – is less than one third the width of the tooth and takes up less than 50% of the biting surface. Larger cavities with inadequate tooth to support a filling are best restored using porcelain.

2. A cracked tooth

If the tooth is cracked, a porcelain restoration is needed to protect the tooth from fracturing. We commonly see cracked teeth when silver fillings, especially large ones, have been in place for many years.

3. Worn teeth

Teeth which are worn can be restored with either material depending upon the extent and location of wear. Surfaces which receive heavy biting forces require the strength of porcelain to last a reasonable length of time.

4. Root canal

Teeth which have had root canal therapy generally require porcelain crowns to protect them from breakage, as these teeth are brittle and somewhat hollow as a result of the root canal.

5. Tooth Modifications

Sometimes teeth are restored to alter their shape and or appearance. Examples are gaps between teeth, poorly aligned teeth and teeth which are restored to improve the bite. Larger modifications require the use of porcelain.

Today’s porcelains are much different from those that were used only 10 to 15 years ago. Newer technology has produced ceramic materials with exceptional strength as well as a lifelike appearance. In addition, these materials can be used to make crowns, commonly known as “caps”, which cover the entire tooth.

They can also be used as onlays or “partial caps” to preserve solid healthy tooth structure. These onlays are beautiful and long-lasting restorations which can be less costly than full crowns.

If you have any questions about which fillings are appropriate for you, please do not hesitate to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

I have had the pleasure of working with several wonderful dental technicians and laboratories and during the past three decades. Since it has always been our goal to provide excellent dental care for our patients, selecting the right dental laboratories to be our partners was critical. In the process of advancing our dental techniques and treatment planning, it was incumbent upon us to find dental laboratories and technicians who shared the same philosophy and passion to do great work. In that regard, to find a good fit, we depended upon word of mouth from our peers. Such has been the case since the late 1980’s and several labs with whom we have worked deserve our sincere thanks.

Back in the late 80’s and early 90’s, the use of gold for fine dental restorations was still common. So, to learn how to provide excellent gold inlays and onlays, I took advantage of an opportunity to become a member of the exclusive Richard Tucker Gold Study Club. Members of this club met in dental offices and brought actual patients on whom to practice their technique. These doctors were very particular; Tucker trained doctors used only Tucker trained technicians. As a result, I was fortunate to have met a man named Dale Jones who handmade the finest gold restorations I had ever seen. Times have changed, and patients no longer wished to have gold visible in their mouths. So we began doing a similar service using modern dental ceramics for beautiful restorations. The problem was that Dale did not work with porcelain, but I asked him if he knew someone who was as good with porcelain as he was with gold. That is how I was introduced to Krisann Shaler and her lab called Porcelain Designs.

Kris and I began working together in the early 90’s and we still work together today. Her lab is in California, but we were able to spend some quality time together around the year 2000. We arranged to meet while I was taking a course at the Las Vegas Institute and it was then that Kris, Dale and I, along with our spouses, went to dinner and got to know each other on a personal level. Kris actually made the restorations for my wife, Liz, that were being prepared while I was attending courses at the Las Vegas Institute. When I inserted these restorations, the other doctors with whom I attended classes and the teaching doctors commented on how beautiful the porcelain work was. Kris is still providing beautiful restorations like those for my patients today.

As I learned more about restoring patients with major bite problems, the need arose for more complex restorations using increasingly difficult techniques. As a result, I was introduced to larger laboratories that had both the necessary equipment and knowledge to produce these complex cases. The two labs which have provided this fine service deserve to be thanked as well and their names are Aurum Ceramic Dental Laboratories and Microdental Laboratory. Each of these labs have several outstanding technicians, but I’d like to call out Ulf from Aurum and Gloria from Microdental who have acted as integral members of our team during the production of many of our larger cases.

There are several other laboratories with which we have worked over the years and they deserve our gratitude as well. Many times, it is these laboratories who make us look good because they allow us to provide excellent care and service for our deserving patients. So in closing, I’d like to give a huge Thank You to Dale, Krisann and all of the lab technicians who have taken such great care of us for the last 30 years.

Perhaps it will not be so surprising to hear that when a person graduates from dental school, he or she still has much to learn. To that end, there are a variety of post graduate teaching institutes available to engage those dentists who choose to carry on the learning process. There are schools or curricula for learning implants, dentures, crowns and bridges, cosmetics, TMJ and a variety of specialties and sub-specialties. It is up to each individual dentist to decide which path he or she chooses to pursue.

After graduating from dental school, and having served an “apprenticeship” in offices other than my own, I knew that basic drill and fill dentistry was not for me. I found that the study of occlusion – how the teeth, jaws and muscles work as a system – was fascinating for me and provided the basis for practicing dentistry with excellence. What we were taught about occlusion in dental school was adequate for a basic understanding only. So, I decided to begin studying this subject and have been studying it ever since.

I will be writing thank you letters to the important mentors in my life later this month, but I must mention Dr. Peter Dawson who is considered by many to be the father of modern occlusion–he actually wrote the book on it. In the late 1980s, I traveled to Richmond, Virginia to take a course from Dr. Dawson. As luck would have it, I ran into him at a restaurant in the airport as I was traveling home after his course. We had a very interesting conversation, and he suggested that I attend the L. D. Pankey Institute in Florida if I was serious about learning and understanding occlusion. I came to learn that this Institute was the premier of its kind and was attended by dentists from all over the world. So I did enroll as Dr. Dawson recommended.

I traveled to Key Biscayne, Florida on several occasions for the multi-day courses which were offered at this beautiful institute. I pursued the study of occlusion there over a four-year period and learned much, much more than simply occlusion. We learned about the practice of dentistry as well as a philosophy encompassing the balance between work, play, love, and spirit. The L.D. Pankey Institute changed my life, and allowed me to provide a level of dentistry of which I could be quite proud.

Many years later, as Y2K approached, I became fascinated with providing more and finer cosmetic dentistry for my patients. At that time, the economy was in major growth; and patients had the desire as well as the means to improve their appearance. I had heard about a place called the Las Vegas Institute where outstanding cosmetic dentistry was being taught. The name of the Institute caused a bit of apprehension on my part, because I assumed that dentists went there simply because of its location, but I proceeded to take a course there. I actually brought a patient and performed her dentistry in their clinic after the associated classroom lectures. The patient who came with me was my wife, Elizabeth, and both she and I were ecstatic with the result.

As it turned out, students from all over the world also attended this teaching institution, and like my experience in Florida, they taught a philosophy of dentistry with which I became intrigued. It is here where I learned a different point of view about occlusion, and it is here where I developed my ability to better help those with Temporomandibular Joint Dysfunction and head or facial pain. I traveled there on many occasions over a period of more than 10 years and completed their entire curriculum of courses. During that time, the quality of my dentistry constantly improved and I loved the entire process.

I feel blessed to have found each of these two institutions which helped to shape me into the dentist that I am today. It is the dedicated teachers and researchers at these facilities who provided such amazing information about technique and materials as well as the philosophical basis for providing excellence in dentistry and life in general.

The next time that you are in the office, you will see two walls which are covered with certificates from those institutes. I am proud to have attended these two prestigious schools and THANK them for shaping my career into one of which I am proud.

In this article, we would like to share with you seven of our favorite products and technologies. These are all items or services which we as a team use on a regular basis and recommend to our patients. We feel that each of these is the leader in its field and offers solid benefits. So, without further ado, here is the list:

Number 1: Sonicare Toothbrush

Through the years, we have recommended a variety of toothbrushes ranging from the Rotadent to Oral-B and finally to Sonicare. In our estimation, the Sonicare electric toothbrush is simply the most effective tooth cleaning product on the market. End of story. Having used and Oral-B electric tooth brush for many years and having avoided the Sonicare because I found it to be uncomfortable initially, I began using it regularly and discovered that it was far superior at removing stains and plaque and maintaining gum health. What more is there to say?

Number 2: Closys Toothpaste

We have been recommending Closys toothpaste for the last 10 years or so. It contains chlorine dioxide which kills germs. It does not contain abrasives, extra chemicals or other unnecessary ingredients which would make it a lesser choice for effective oral health. Closys II toothpaste effectively kills germs, helps maintain gingival and dental health as well as providing clean fresh breath.

Number 3: Inter Dental Cleaners

There are a variety of ways to clean between the teeth which we recommend for different patients and for different reasons. I will lump these together as being the third most important thing we love. For those with regular spaces between our teeth, we love Reach Total Care floss by Johnson and Johnson. This is great floss which is effective, tastes good, and is well-designed.

If you have bridges and are unable to use regular dental floss, then Superfloss by OralB is the choice for you. This product allows you to easily thread the floss underneath your bridges and thoroughly clean them with a minimum of fuss.

For those who have very wide spaces between their teeth, pipe cleaners are an excellent choice to quickly and effectively clean between your teeth. For those with moderate spaces between their teeth and for those who have had gum surgery ProxaBrushes are the weapon of choice. They are easy to hold and manipulate and are effective at cleaning larger spaces between your teeth. Finally for those people who hate to floss, there is a product by Sonicare called the AirFloss are which is very effective especially at removing debris which gets caught between your teeth.

Number 4: NeoStrata Skincare

We have offered the line of NeoStrata skin care / antiaging products in our office for the past few years. Though it has not been very popular amongst our patients, it is very popular with our dental team. This line of products is meant to care for your skin and these products do what they say they will do. If you have any interest, feel free to ask us for samples and I think that you will be surprised at how effective they are. For your information, this little-known company provides products to various larger corporations whose names you may well know.

Number 5: Zoom! Teeth Whitening

For many years, we used the BriteSmile system for teeth whitening. Zoom! Whitening became the standard for tooth bleaching when the show Extreme Makeover was so popular. Some years ago Zoom! Purchased BriteSmile and their newest system offers improvements which make the procedure both more effective and comfortable. For those people who desire whiter teeth, the in-office Zoom!bleaching system is the best.

Number 6: Invisalign

Invisalign orthodontics has been available for more than a dozen years. This company continually up grades their techniques and products to offer an excellent alternative to metal braces. There are various bite problems which can now be addressed using Invisalign, and more and more adults are taking advantage of this excellent service to help turn back the clock. FYI, the Invisalign system aligns and levels the teeth using a series of clear aligners which are changed by the patient every two weeks. The results we have achieved with this system have been very impressive.

Number 7: The K7 and TMD Orthotics

We purchased the K7 technology many years ago to assist us in treating patients with head, neck and facial pain. This system has proven to be a wonderful way to help diagnose our patients’ problems and to determine the best way to treat them. Using this system, we are able to have orthotics custom fabricated for patients to wear over their lower teeth. These orthotics have been very effective at eliminating various symptoms of TMD pain and associated symptoms. If you suffer from chronic pain, I recommend that you ask us about how the K7 system and an orthotic may be a blessing for you. Check out this technology at www.myotronics.com.

It is our hope that you find these seven of our favorite things to be useful for you. If you have any questions about any of these items, please do not hesitate to ask. You may contact us by phone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com.

Earlier this month, we discussed common dental problems which affect us as we grow older and how to address them. In this installment, we will describe three popular methods to improve both the appearance and the function of your teeth. At the end of this article, we will reinforce what we believe to be the best ways to improve the health and beauty of your smile.

You may be surprised to hear about the first popular procedure which has increased in frequency over the past several years. Once considered only appropriate for adolescents and teenagers, orthodontics has become an excellent means for adults (even those well into their 60s) to improve their smile, take years off their facial appearance, and improve their self-esteem. This, in turn, improves their overall outlook on life. Alternatives to the metal braces commonly seen in the past have grown in popularity as they have become more comfortable, effective and invisible. In our office, Invisalign™ orthodontics has proven to be a discrete and successful method for adults to address bite issues and crooked teeth. Even patients who had braces as a teenager find the system an excellent way to realign teeth which have relapsed over the years.

Invisalign™orthodontic treatment, combined with either tooth bleaching and/or bonding, can help you to achieve your dream smile, improve your appearance, help you look younger, and feel a renewed sense of self confidence. In addition, a properly aligned bite serves to preserve your overall health and well-being. Teeth which are not aligned and bites which are not properly balanced are much more at risk for a variety of dental issues. These issues include tooth fractures, tooth wear, loosening teeth, gum recession, ineffective chewing ability as well as a variety of jaw, neck, and shoulder pain and headaches.

The second popular dental enhancement which has steadily gained in popularity over the last twenty-five plus years is implants. Titanium implants have evolved and become a staple in the replacement of missing teeth for those who wish for comfort, convenience, and excellent appearance. Implants can be used in a number of different ways to replace missing teeth. The simplest way, of course, is for replacing a single missing tooth. But implants can also be used to replace a series of missing teeth or even an entire arch of missing teeth. Contrary to popular opinion, the placement of implants does not involve significant discomfort and their success rate is very high.

There are many patients who have struggled with dentures for years. Such patients have had as few as two implants placed to stabilize their existing dentures. The benefits of such procedures are astounding for those who have struggled to eat and speak with loose plates for years. We even see patients who are about to lose all their remaining teeth in one or both arches. Such patients can have their hopeless teeth removed, four implants placed, and a set of teeth mounted on those implants all in a single appointment. That procedure is called “All-On-Four” and requires collaboration between a prosthetic dentist, an implant surgeon and a laboratory technician. The results in these cases are life changing.

The third popular smile enhancement involves bonding or porcelain to restore worn, broken, or otherwise damaged teeth. “Bonding” utilizes tooth-colored filling material which is placed on one or a group of teeth to restore natural appearance, shape, and color. Similarly, porcelain is used in more advanced cases for those patients who wish to have the most long-lasting and cosmetic solution to their dental problems. Porcelain can be used to cover the entire tooth or limited areas of the tooth as needed in any given situation. The porcelain is bonded to the teeth which results in a very strong, cosmetic, and natural result.

Bonding and porcelain can be used to enhance smiles in a number of different ways. Teeth which have mild misalignment can be made to look perfectly aligned instantly using these materials. Similarly, problems with symmetry, proportion, color and shape can all be addressed using these materials. The next time that you are in our office, make sure to look at some of the photographs on our walls which exhibit the results gained by using these materials.

Finally, let us reiterate the best ways to ensure healthy aging at least as far as oral health is concerned. As we grow older, we are all more prone to have decay which can sometimes develop very quickly. It is not uncommon for adult patients to have some gum recession which results in the exposure of root surfaces. Such surfaces are very prone to decay and must be carefully monitored both at home and in the dental office. In addition, as our gums recede, food is more likely to lodge between the teeth creating another cause for decay developing. Increased use of medications and other medical issues may lead to a condition of dry mouth. Without the buffering effects of saliva, the likelihood for increased dental decay as well as gum disease is highly likely.

So what is one to do to prevent an increase in gum disease and dental decay? Here are our favorite as well as most effective recommendations:

Rinse with a fluoride mouthwash especially before bed. During this month we have been handing out Listerine Zero which is a good product found in the grocery store but any similar product which includes no alcohol can be used.

Have regular checkups! This is the best way to make sure that small problems do not become big ones! In the past few years, we have seen more and more patients who have returned after extended periods with more severe problems. Regular checkups will save you money and give you more peace of mind.

In closing, cosmetic dentistry may be key to a person’s health in later life. Here is a quote from a cosmetic dentist in Texas:

“We often hear older patients just wanting things patched up as opposed to getting something aesthetic. They may have the idea that they are not worth it, or their families have the idea that they are too old for cosmetic dentistry. This may lead to an attitude that things are ending.

“Improving an older person’s mouth can bring them more happiness and joy, not only by improving chewing efficiency, but also bringing joy back. They will want to smile more.”

If you have any questions concerning this article or any other dental questions, please call our office at 908.359.6655 or contact us via our website at www.designsfordentalhealth.com.

For over 20 years, September has been designated healthy aging month. This is an annual celebration of the positive side to growing older. During this month, a variety of sources provide Inspiration and ideas for baby boomers and adults aged 45 and above to help them to improve their physical, mental, social, as well as financial well-being.It is our hope that we at Designs For Dental Health can provide some pertinent information to contribute to our fellow baby boomers.

It is interesting to note that there are over 76 million baby boomers today over the age of fifty and the first of the 82 million Generation X-ers are about to reach that milestone in 2015. Why not use September as a time to look back on where you’ve been and consider what you might truly like to do with the rest of your life.If you’re happy and fulfilled with what you’re currently doing, keep on keeping on!If not, this is definitely the time to make a change.From my point of view, I’m happy to keep on doing what we, as your dental care providers, love to do most. Help to keep you healthy!

So, with that in mind, here’s our question for you today: How’s your smile?

First of all, research supports the idea that those who smile more are just plain happier. Secondly, those with a healthy mouth are much less likely to develop a myriad of diseases commonly suffered by those of us in the 60+ population. So ask yourself- when is the last time that you had a comprehensive dental examination to determine your overall oral health and the best methods used to maintain it? I promise to provide such a comprehensive examination free of charge for anyone over age 55 who has been a patient in our practice for more than 5 years and who requests it.That’s right! All you have to do is ask! I’ll sit down with you for as long as it takes to discuss your concerns and desires.Then, we’ll do a comprehensive examination including an oral cancer screening, evaluation of your teeth, gums, and bite. Together, we’ll discuss any options that might be available to you to improve your dental health and from that discussion we will arrive at the best treatment plan for you.

Consider this – a mere 60 years ago, it was assumed that we would lose all of our natural teeth as we aged.Now we know that a healthy mouth and teeth will help you to not only look good, but to eat delicious and nutritious foods, to speak clearly and to be confident.An excellent quality of life demands a vibrantly healthy mouth. Just consider the fact that those whose oral health is subpar are at risk for various serious medical conditions including: heart disease, stroke, diabetes, pneumonia, cancer, and various other diseases which are common in older adults.

What are some common oral health problems?

Dry mouth.Reduced salivary flow is most commonly the result of cancer treatments, the use of certain medications, and certain diseases. Dry mouth is a significant cause of decay and gum disease in older patients because saliva serves to buffer acids that are produced as we eat. Without the protection of these buffers, rapidly advancing problems occur.

Darkened teeth.Our teeth tend to darken with time as the pulp in our teeth recedes and the outer layer of enamel becomes thinner, thus allowing the darker dentin to show through. There are various methods available to whiten the teeth for a more youthful appearance. These techniques do not harm teeth and most patients are extremely happy with their whiter, more beautiful smiles.

Root decay. As the gums recede, exposure of the tooth roots result. Exposed root surfaces are less resistant to decay than enamel and decay here is quite common. Good brushing and plaque removing habits go a long way to protect these surfaces. In addition, the judicious use of fluoride rinses can be most helpful to protect these exposed surfaces.

Gum disease. Inflammation of the gums and resulting bone loss in more advanced cases is quite common in adults over the age of 50. Gum disease is worsened by poorly fitting tooth restorations, less than ideal dietary choices, and certain diseases like anemia, cancer, and diabetes. The best way to fight gum disease is to practice excellent oral hygiene and have regular dental exams and cleanings as recommended in your particular case.

Tooth loss. Gum disease is the number one cause of tooth loss; however, teeth which have broken due to old, large silver fillings or simple attrition require prompt attention to avoid unnecessary loss of teeth! Restoring a broken tooth is always better and less expensive than losing a tooth and later trying to replace it.

Uneven jawbone. This common problem is a result of premature tooth loss.Once a tooth is lost, the bone previously around that root vanishes and teeth adjacent to and opposing the missing tooth will shift.This causes an uneven bite and places for food and bacteria to become trapped.

So what is the best way to maintain your good oral health?It’s the same regardless of your age!

Brush at least twice a day with good quality toothpaste as recommended by your dentist or hygienist. The most important time to brush is just before bed!!

Floss or otherwise thoroughly clean between your teeth at least one time each day.

Visit your dentist or hygienist on a regular basis as recommended by them for regular cleanings and oral examinations.

Use appropriate rinses or fluorides or other such adjuncts as recommended by your dental professionals.

If you have any questions about healthy aging month or would like a complementary comprehensive examination please call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

As I mentioned in our last blog, we will be describing various connections between oral health and systemic (or total body) health. Today, I’d like to report on a very interesting class which I attended about a week ago. This was an Invisalign Study Club meeting which was meant to increase our skills in planning Invisalign orthodontic cases. But, every now and then, we watch a gifted speaker provide you with much more information than the announced topic would suggest.

My longtime patients know that I have been a lifelong student of dentistry and especially occlusion’s (the bite’s) role in preserving dental health for the long term. I have studied the various connections between occlusion and overall health including TMD and head/neck pain, occlusion and advancing gum disease, as well as occlusion and the airway to name but a few.

Well, at this particular lecture, the speaker showed slides of various patients with crowded teeth as well as some with narrow dental arches. Many of these patients, like many of those I see every day in my office, have what we call, tori, on the inside of their lower jaws. Patients are often aware of these tori, most are generally not bothered by them, but some ask if they should be concerned about them. I had always considered these to be a sign of patients who are chronic clenchers of their teeth, and many of them are. However, the speaker made a legitimate case for the chronic growth of these tori in patients whose teeth are tipped towards the tongue.

But perhaps I am getting off of the point. The combination of people who have narrow jaws and tooth crowding are very likely to have sleep apnea. I have always known that there is a connection between narrow jaws and sleep apnea, but this presentation made it so clear that patients like those described above do not have adequate space in their mouth for their tongues. As a result, their tongues are forced back into their airways, and the result is sleep apnea.

Such patients may have had orthodontics when they were children,and had four teeth extracted because of their crowding. Such patients are quite likely to have sleep apnea because their jaws are narrow and their teeth have been moved back to where the tongue wants to be to close the space created by the extracted teeth. The tongue is thereby forced to rest towards the airway. Now, I am considering whether or not to treat such patients orthodontically to expand their arches. This is one means of improving their airways and reducing their likelihood of developing obstructive sleep apnea.

When such patients come to my office, they must be carefully screened for obstructive sleep apnea, high blood pressure, adult onset diabetes, cardiovascular disease and other systemic issues which are related to obstructive sleep apnea.

If you have a bite which sounds like the type that I have described above, please contact us so that we can perform a proper screening for obstructive sleep apnea. If you have any questions about your occlusion or sleep apnea, please feel free to contact us by telephone at 609.359.6655 or via our website at www.DesignsForDentalHealth.com

All–on–4® is the name for a technique used in the total rehabilitation of patients who have lost or will soon lose all of their teeth in one or both arches. This system was developed in the 1990s through studies which were funded by Nobel Biocare which has been a corporate leader in the implant industry since the early 1980s.

The All-on-4® treatment concept is a miracle because patients arrive at their dentist’s office in the morning with either no teeth or teeth which cannot be saved in one or both arches. At that appointment, the implant surgeon (usually a periodontist or oral surgeon), the prosthetic dentist (in this case, me) and a lab technician work collaboratively.A few hours later the patient leaves the office with a complete set of teeth which are not removable, which function well and which look amazing.

In addition, no grafting is required before placing the implants with this system. Therefore, most patients who have been told that they are not good candidates for implants because of a lack of bone, or large sinuses, or other anatomical circumstances are perfect candidates for the All–on–4® procedure.

There is no grafting, and no lengthy healing time required. Four implants are placed in each treated jaw. This procedure takes advantage of the dense bone which is available in the front of both the top and bottom jaws and places two implants there. Two more implants are placed in the back of the jaws and at an angle to both avoid sensitive anatomic areas as well as to take advantage of available dense bone there. Permanently fixed bridges can then be secured to these four implants immediately because of the solid primary stability which is gained by these strategically placed implants.

The full dental bridge which is attached to these implants is not removable, has no coverage of the palate, and can be used immediately to eat a complete diet without restriction. After four to six months, a final fixed prosthesis is placed over the implants once total healing is assured.

The advantages of All–on–4® are many:

1. Get implants in one day with minimal surgery.

2. Entire procedure completed in one location and one day.

3. Avoid the expense and healing time of bone grafting.

4. Have fixed, not removable teeth.

5. Have a complete new set of teeth which look and feel natural – Smile Again!

6. Have the ability to again eat all the foods that you desire.

If you have any questions about the All–on–4® procedure or if you know someone who would benefit from it, please contact us at 908.359.6655 or via our website at www.designsfordentalhealth.com